NUTRITION SURVEY IN AFDER AND LIBEN ZONES (SOMALI REGION) AND BORENA ZONE (OROMIYA REGION)

EXECUTIVE SUMMARY

Following reports of increased food insecurity in Somali region (Afder and Liben zone) and Borena zone (Oromiya region) a nutritional survey was undertaken in these zones between 1 February and 4 March 2000. The survey was commissioned by Norwegian Church Aid (NCA),Dutch Interchurch Aid and the South Ethiopian Synod of the Ethiopian Evangelical Church, Mekane Yesus. The survey team was led by a senior nutritionist, Ato Berhanu Hailegiorgis, assisted by Sr Melkie Teferi, and consisted of relief and health staff of the South Ethiopian Synod.

The survey involved 36 peasant association (PAs) from Afder and Liben zones and 31 PAs from Borena zone. A total of 3,300 children under five years of age were included for body measurements (weight and length). Other supporting information on market condition, levels of mortality and morbidity, dietary pattern, livestock and water condition were also collected.

Nutritional status in all surveyed weredas has fallen below the 90% WFL cut-off point for emergency assistance as defined by the Disaster Prevention and Preparedness Commission (DPPC). Out of 68 surveyed PAs 6 PAs in Dolo odo and Afder zones and 11 PAs in Borena zone have mean WFL% less than 85%, the cut-off point for serious level of malnutrition. Five PAs in Dire, IPA in Yabello (Borena zone) and 1PA in Bare (Afder zone) have mean WFL% less than 80%. Such levels of malnutrition are probably the highest recorded among similar surveys in the country.

Lack of pasture, water and animal diseases have already caused death of a large number of cattle and shoats. Current market prices were assessed both by team members and also by reference to the relevant wereda Agriculture Office. Among 307 interviewed households in the three weredas of Borena zone, 2088 cattle and 64 shoats died during the last six months. Similarly, 351 households in three weredas of Afder and Liben zones reported 1297 cattle and 3892 shoat deaths during the same period. Among the dead, calves and productive cows constitute the greater part. The survey team has also witnessed many carcasses of dead cattle in Borena zone.

A rough estimate of crude mortality rate in all surveyed weredas was much higher than the national average. Crude mortality rate among the study population (n=2596) in the three weredas in Afder and Liben zones (Somali region) was 48 per 1000 population. Among the sample population of 2028 in Borena zone (3 weredas) the rough estimate of crude death rate was 28 per 1000 population. The proportion of all under five deaths to all deaths was 52.6% in Borena zone (3 weredas) and 72% in Afder and Liben zones (3 weredas).

Among the study children (n=2028) in Borena zone (3 weredas) 36.8% had diarrhea, 39.1% cough and 31.6% fever two weeks prior to the survey date. In the three weredas of Afder and Liben zones (n=2596) diarrhea was reported in 64% of the children while cough and fever occurred in 80.3% of them. It is likely that infectious diseases have contributed to the observed high mortality rate in the survey areas.

Immunization (EPI) and most other primary health services are totally absent in the study weredas in Afder and Liben zones. In the three study weredas of Borena zone, immunization services are provided in most health centers, clinics and through outreach programmes. However, the services need further strengthening with logistics, equipment and fund.

A rough estimate of crude birth rate in the sample population (n=2028) in Borena was 72 per 1000 population far exceeding the national average. In Afder and Liben zones (3 weredas) the crude birth rate was roughly 42 per 1000 population a level close to the national average.

A change in food consumption pattern were also observed among the study children in all study weredas. The number of meals consumed per day has decreased both in quantity and quality compared to normal times. Because of poor livestock productivity, most pastoral households in all weredas have shifted their usual dietary consumption from milk to grain and tea. The situation in Borana was all the more alarming because children are generally prioritised in the distribution of food within the family.

In addition, driven by recurrently occurring drought, those who normally consume their own produce milk and maize at this time of the year are now dependent on purchased and aid food. Most of the poor groups of the pastoral community have already started consuming wild fruits and leaves. The abnormality of the dietary pattern has gone as much as serious as to eating monkeys and dead wild cats as reported by the communities in some of the PAs in Borena zone.

All the 351 study households in the three weredas of Afder and Liben zones get their water supply from unprotected sources. More than 92% of the interviewed households in Borena zone (n=307) fetch water from unprotected sources. More than 86% of the sample households in Borena have changed their water sources and were forced either to walk to the new sources much more time than the old sources or depend on the scarce water rationing going on in the area. Only 10.8% of the sample households in Afder and Liben zones have changed their water sources.

RECOMMENDATIONS

1. Since the most acute problem is food shortage, the urgent measure should be the distribution of supplementary food to targeted children under five years of age and their mothers in the severely affected weredas and villages. This should be done along with adequate distribution of grain (basic ration) so as to avoid family sharing of the supplementary food. Any delay in food assistance will increase the risk of mass death in the severely affected areas.

2. Since the visited sites were in sample weredas and villages, it is more likely that a similar situation of severe food shortage may exist in other weredas and villages not surveyed by the team. Hence there is a need for monitoring the situation of the other areas.

3. Temporary nutrition rehabilitation services should be provided in all health institutions of the severely affected weredas to handle the severe forms of malnutrition (under 60% weight for length) and minimize the risk of death. The necessary feeding materials and screening equipment should be provided to the health institutions.

4. Short training should be given to the health staff in the affected weredas to enable them manage severe cases of malnutrition and diarrhoea.

5. Another nutritional survey should be conducted in May, 2000 and a regular nutrition surveillance system should be initiated in the most vulnerable areas of the zones.

6. EPI activities should be urgently initiated in the surveyed weredas of Afder and Liben and support is highly needed to the ongoing EPI programme in Borena zone.

7. The very high incidence of infections diseases should be urgently arrested by providing essential drugs and medical supplies as well as alleviating the shortage of man power and health facilities.

8. School feeding programmes in Borena zone should be expanded and new feeding programmes should be started in Dolo-odo, Dolobye and Bare weredas of Liben and Afder zones.

9. Emergency rehabilitation and maintenance of non-functional water sources and water rationing for severely affected areas are timely responses to the critical water shortage in Borena zone. Construction of bore holes, cisterns and ponds are top priorities in mid-term interventions in the zone.

10. Provision of more water pumps to communities residing along the Genale, Web and Dawa rivers will inevitably have a far reaching impact on the food security of these areas. Maintenance of the existing non-functional water pumps will also considerably solve the current food shortage problem in pocket areas.

11. Since livestock diseases are aggravating the worsening livestock condition in the surveyed areas, it will be timely to initiate new veterinary services or strengthen the existing ones.

12. As more pastoralists in the studied areas have started to engage extensively into crop production, agricultural extension services should be initiated among the pastoral communities.

LIST OF TABLES

TABLE 1:- Nutritional status classification

TABLE 2:- Nutritional status by wereda in Borena zone

TABLE 3:- Nutritional status in Dolo Odo wereda

TABLE 4:- Nutritional status in Bare and Dolo bye weredas

LIST OF APPENDIXES

APPENDIX A:- Nutritional status of children by wereda and PA in Borena zone

APPENDIX B:- Demographic and dietary pattern of households in Borena zone

APPENDIX C:- Health condition in Borena zone

APPENDIX D:- Condition of water in Borena zone

APPENDIX E:- Livestock condition in Borena zone

APPENDIX F:- Market condition in Borena zone

APPENDIX G:- Nutritional status of children by PA in Doloodo Bare and Dolobye weredas

APPENDIX H:- Demographic and dietary pattern in Dolo odo, Bare and Dolo bye weredas

APPENDIX I:- Health condition in Doloodo, Bare and Dolobye weredas

APPENDIX J:- Water condition in Doloodo, Bare and Dolobye weredas

APPENDIX K:- Livestock condition in Doloodo, Bare and Dolobye weredas

APPENDIX L:- Market condition in Doloodo and Bare weredas

ANNEX 1:- List of Participants

ANNEX 2:- Questionnaires